Response Shift and Glycemic Control in Children With Diabetes.

BACKGROUND: The purpose of this study was to investigate the scale recalibration construct of response shift and its relationship to glycemic control in children with diabetes. METHODS: At year 1, thirty-eight children with type 1 diabetes attending a diabetes summer camp participated. At baseline and post-camp they completed the Problem Areas in Diabetes (PAID) questionnaire. Post-camp, the PAID was also completed using the 'thentest' method, which requires a retrospective judgment about their baseline functioning. At year 2, fifteen of the original participants reported their HbA1c. RESULTS: PAID scores significantly decreased from baseline to post-camp. An even larger difference was found between thentest and post-camp scores, suggesting scale recalibration. There was a significant positive correlation between year 1 HbA1c and thentest scores. Partial correlation analysis between PAID thentest scores and year 2 HbA1c, controlling for year 1 HbA1c, showed that higher PAID thentest scores were associated with higher year 2 HbA1c. CONCLUSION: Results from this small sample suggest that children with diabetes do show scale recalibration, and that it may be related to glycemic control.

Age Related Differences in Individual Quality of Life Domains in Youth with Type 1 Diabetes.

BACKGROUND: Investigating individual, as opposed to predetermined, quality of life domains may yield important information about quality of life. This study investigated the individual quality of life domains nominated by youth with type 1 diabetes. METHODS: Eighty young people attending a diabetes summer camp completed the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting interview, which allows respondents to nominate and evaluate their own quality of life domains. RESULTS: The most frequently nominated life domains were 'family', 'friends', 'diabetes', 'school', and 'health' respectively; ranked in terms of importance, domains were 'religion', 'family', 'diabetes', 'health', and 'the golden rule'; ranked in order of satisfaction, domains were 'camp', 'religion', 'pets', and 'family' and 'a special person' were tied for fifth. Respondent age was significantly positively associated with the importance of 'friends', and a significantly negatively associated with the importance of 'family'. Nearly all respondents nominated a quality of life domain relating to physical status, however, the specific physical status domain and the rationale for its nomination varied. Some respondents nominated 'diabetes' as a domain and emphasized diabetes 'self-care behaviors' in order to avoid negative health consequences such as hospitalization. Other respondents nominated 'health' and focused more generally on 'living well with diabetes'. In an ANOVA with physical status domain as the independent variable and age as the dependent variable, participants who nominated 'diabetes' were younger (M = 12.9 years) than those who nominated 'health' (M = 15.9 years). In a second ANOVA, with rationale for nomination the physical status domain as the independent variable, and age as the dependent variable, those who emphasized 'self care behaviors' were younger (M = 11.8 years) than those who emphasized 'living well with diabetes' (M = 14.6 years). These differences are discussed in terms of cognitive development and in relation to the decline in self-care and glycemic control often observed during adolescence. CONCLUSIONS: Respondents nominated many non-diabetes life domains, underscoring that QOL is multidimensional. Subtle changes in conceptualization of diabetes and health with increasing age may reflect cognitive development or disease adjustment, and speak to the need for special attention to adolescents. Understanding individual quality of life domains can help clinicians motivate their young patients with diabetes for self-care. Future research should employ a larger, more diverse sample, and use longitudinal designs.

RELATIONS AMONG REMEMBERED PARENTAL ACCEPTANCE AND BEHAVIORAL CONTROL IN CHILDHOOD, ADULTS' CURRENT PSYCHOLOGICAL ADJUSTMENT, AND CAREER INDECISIVENESS

This study tested the hypothesis that career indecisiveness among men tends to be associated with different levels of self-reported psychological adjustment and with different remembrances of parental (maternal and paternal) acceptance and behavioral control in childhood from those of women. One hundred twenty-six respondents ages 17 through 54 (M = 23.7 years, SD = 8.21 years) participated in this study. Thirty-seven where males; 90 were females. Measures used in this study included the Career Decision Scale, the Adult version of the Parental Acceptance-Rejection/Control Questionnaire for mothers and for fathers, and the Adult version of the Personality Assessment Questionnaire. Both men and women remembered their mothers as well as their fathers as being loving in childhood. Additionally, men and women remembered both parents as being moderately behaviorally controlling in childhood. Finally, both men and women reported a fair level of psychological maladjustment. And on average, both men and women were fairly indecisive about their careers. Results of analyses supported the hypothesis in that career indecisiveness among women but not men was significantly correlated with remembered maternal and paternal acceptance in childhood, as well as with self-reported psychological adjustment and age. However, only women’s self-reported psychological adjustment made a significant and unique contribution to variations in their reports of career indecisiveness. None of the predictor variables were significantly associated with career indecisiveness among men.